The pattern is now quite familiar – a study looking at some physiological outcome while rats or mice are being jabbed with needles is breathlessly presented as, “finally we know how acupuncture works.” As is always the case, a closer look reveals that the study shows nothing of the sort.

The study presents two experiments with rats in which there is a control group, a stress group, stress plus acupuncture, and stress plus sham acupuncture. The first thing to notice is that the rats were not actually getting acupuncture. They were getting the fiction known as “electroacupuncture.” Electroacupuncture is not a real thing – it’s just electrical stimulation through a needle which is called an acupuncture needle.

The authors claim that their results show that electroacupuncture (EA) at the St36 acupuncture point (which is behind the leg), but not sham EA on the back blunt the stress response as measured by cortisol levels, ACTH, and stress behavior in the rats.

Just looking at the data itself, separate from the context of acupuncture, there are a few things to notice. The first is that the study is very small, with (in the first experiment) 7 rats in the control and stress groups, and 14 rats in the EA and sham EA groups. That’s not a lot of data points. There is no mention of blinding anywhere in the study. Unless everyone involved in those aspects of the study measuring outcomes were effectively blinded, I see no reason to take the results seriously.

Further, the results are completely unimpressive. The differences are slight. The researchers also pull a common statistical trick. They say, for example, that the difference between control and EA was statistically significant, while the difference between control and sham EA was not. However, they don’t tell us whether or not the difference between EA and sham EA was significant (and by looking at the data I would guess not).

It is therefore not valid to conclude that there is a difference between EA and sham EA. This is a common statistical “mistake” researchers make, probably having something to do with the fact that it makes negative data look positive.

It is possible that this study tells us nothing at all. Given the small number of rats in the study, no documentation about blinding, and the unimpressive results, just a touch of researcher bias (exploiting those researcher degrees of freedom) is all that is necessary to get the graphs to look good enough to publish.

Therefore, regardless of the subject matter, these are preliminary results at best, and unimpressive preliminary results at that.

If we put these results into the context of acupuncture, we then have the equivalent of Bem’s psi research – unimpressive results used to support a massive claim.

This ancient Chinese medical tradition stretches back over 3,000 years, the wisdom of the ancients producing medically valid results even today. As in antiquity, slender needles are inserted at precise meridian points on the body and manipulated by a skilled practitioner. Each acupuncture point relates to a specific organ or function in the body, and the practice manipulates the body’s energy, or qi to manage pain and treat a host of conditions including allergies, asthma, headaches, sciatica, insomnia, depression, high blood pressure, fibromyalgia, constipation, and even sexual dysfunction. Acupuncture is, in short, a venerable medical miracle.

Or is it? Let’s cast a skeptical eye at one of the most popular “alternative” medical modalities in the modern world.

Exactly how ancient is acupuncture? Not nearly as ancient as you may think. The first clue is right there in the hands of the acupuncturist: Those slender, flexible, stainless steel needles. The technology to make them didn’t even exist until about 400 years ago.

There are even more historical clues. The Chinese have long kept detailed records. When we examine them we do, indeed, find references to a practice called needling, but the earliest dates to about 90 BCE. The needles from that era were large, and the practice of needling refers to bloodletting and the lancing of abscesses, a treatment nothing like today’s acupuncture. Earlier Chinese medical texts, some reaching back to the 3rd century BCE, never even mention it. There’s no evidence at all that acupuncture is anywhere near 3,000 years old.

No matter. At least acupuncture is Chinese, right? Maybe not.

Chinese scholar Paul Unschuld thinks that the practice may have started in ancient Greece, with Hippocrates of Cos, and later spread to China. A fundamental feature of acupuncture, namely the special meridian points where the needles must be placed, can be traced to the medieval Islamic and European ideas of astrology mapped onto the body. This rather obvious link led researcher Ben Kavoussi to call acupuncture “Astrology with needles” He writes:

…for most of China’s long medical history, needling, bloodletting and cautery were largely practiced by itinerant and illiterate folk-healers, and frowned upon by the learned physicians who favored the use of pharmacopoeia.

Accounts of Chinese medicine first reach Europe in the 13th century. None of them even mentioned acupuncture. Wilhelm Ten Rhijn, writing in 1680, was the first Westerner to reference acupuncture. But what he described bears little resemblance to the acupuncture of today. There was no mention of qi, which is sometimes translated as chi, or any specific points. He spoke of large gold needles that were implanted deep into the skull or womb and left in place for 30 respirations.

The first American acupuncture trials were in 1826, when it was seen as a possible method of resuscitating drowning victims. As Dr. Harriet Hall describes it, “They couldn’t get it to work and ‘gave up in disgust.’ I imagine sticking needles in soggy dead bodies was pretty disgusting.”

Even through the early part of the 20th century nobody spoke of qi or meridians. Practitioners merely inserted needles near the point of pain. In fact, qi used to refer to the vapor arising from food, and the meridians were called channels or vessels, which is part of acupuncture’s link to medieval astrology and vitalism.

So just when and where did meridians enter the picture, and qi finally become some kind of energy?

Alternative Medicine’s best friend, and in my opinion largely responsible for what popularity it has, is a gullible media. I had thought we were turning a corner, and the press were over the gushing maximally clueless approach to CAM, and were starting to at least ask some probing questions (like, you know, does it actually work), but a 2006 BBC documentary inspires a more pessimistic view.

The documentary is part of a BBC series hosted by Kathy Sykes: Alternative Medicine, The Evidence. This episode is on acupuncture. The episode is from 2006, but was just posted on YouTube as a “2014 documentary.” Unfortunately, old news frequently has a second life on social media.

First, let me point out that Sykes is a scientist (a fact she quickly points out). She is a physicist, which means that she has the credibility of being able to say she is a scientist but has absolutely no medical training. It’s the worst case scenario – she brings the credibility of being a scientist, and probably thinks that her background prepares her to make her own judgments about the evidence, and yet clearly should have relied more on real experts.
She does interview Edzard Ernst in the documentary, but he mainly just says generic statements about science, rather than a thorough analysis of specific claims. I wonder what gems from him were left on the cutting room floor.

The documentary does get better in the second half, as she starts to mention things like placebo effects, and the problems with the evidence-base for acupuncture. But she follows a disappointing format – setting up a scientific premise, then focusing on the positive evidence. There is a clear narrative throughout, that acupuncture is amazing and surprising.

Recently in one of skeptics groups that I belong to on Facebook someone posted this picture they found on a conspiracy theorist group:

Apparently conspiracy theorists believe that because some people believe or do certain then that makes them a “terrorist”.

This picture is one of the most blatant examples of persecution complex that I have seen in a while and kind of shows the mindset of a conspiracy theorist.

I’m going to go through all of these claims and explain why believing in these things does not make you a domestic terrorist:

You raise/grow your own food

Why would this make you a domestic terrorist? The answer is it doesn’t.

“Definitely a terrorist – did you see the size of that garden in his backyard?”

Millions of people across the country grow their own food in one way or another, be it either in small plots as a hobby (as my dad does) and as a way to have fresh fruits, herbs, and vegetables, or in greenhouses, or in large fields that provide enough food to feed their entire family. Heck, even the White House has it’s own vegetable garden.

If growing your own food made you a domestic terrorist, then why wouldn’t the government just go around to everyones’ houses and destroy their gardens and green houses? Or pass laws that make it illegal to grow your own food? They wouldn’t because growing your own food is harmless and effects no one.

Oppose GMOs

Opposing GMO foods does not make you a terrorist. It might make you someone who doesn’t understand the science behind GMO foods, or someone who has embraced anti-GMO propaganda, but not understanding science or embracing some group’s claims without questioning them doesn’t make you a terrorist.

If opposing GMO foods made you a terrorist then there would be no organic foods in any grocery store or farmers market anywhere, and no laws meant to either label GMO foods or prevent them from being grown or sold would ever be proposed, much less passed.

Prefer natural medicines

“Is that a cinchona tree i’m feeling?”

If this was true then how come the National Center for Complementary and Alternative Medicine, a official United States government agency that researches and promotes things like natural medicines, even exists?

While the government does restrict multiple types of alternative and natural medicines, this is only because some of them are dangerous, or the manufactures claim it can do something when infact it cannot.

If natural medicines made a person a terrorist then all forms of alternative medicine would be illegal and people who sale it or even promote it would be going to prison.

Refuse vaccinations

Refusing vaccines does not make you a terrorist as there no laws that say that you have to get vaccinated. However, it does make you dangerous to others, as well as your own self as it puts you at greater risk for getting infected with a disease that could kill you, as well as spreading said disease to others who either weren’t vaccinate because they also choose not to (or their parents choose not to have them vaccinated) or a person whom couldn’t get vaccinate for various medical reasons, or someone whom did get vaccinated but the vaccine did not take affect for some reason.

“Is that a a Ron Paul bumper sticker?”

Have a Ron Paul bumper sticker

This does not make you a terrorist, it just makes you someone who likes Ron Paul and refuses to accept the reality that he’ll never be President, and someone who doesn’t know when to take a bumper sticker off of their car.

Last Sunday, April 26, I went down to my town’s annual Earth Day Festival to check out everything that was there, just like I do every year.

Last year I was appalled by the amount of pseudoscience and alternative medicine woo mixed in with all of the legitimate booths and displays promoting legitimate environmental causes and advice [read about it here] to the point where they pretty much overshadowed what the Earth Day festival was suppose to be about.

The worst offender last year of course was a booth promoting Anti-GMO conspiracy theories.

Fortunately that person wasn’t back this year, but still there were people back again promoting the same woo, including the Astrology and Tarot Card reader from last year . . .

. . . and the chiropractors from last year are back as well . . .

. . . but I have some new ones for this year, starting with this one:

Now I admit at first glance this one wasn’t that bad, even through it had nothing to do with environmentalism.

Creating art can help relax a person and cut down on stress. That’s the good part about what’s being presented there.

Then there’s the woo.

They also promote past life regression and trauma healing, clearing of curses, negative spirits, and other stuff of the like, and how to protect yourself from such things, all while using nature and spiritual energy.

In other words instead of addressing any real things that can cause stress in a person’s life, they’re just claiming that it’s supernatural forces, and use “techniques” they claim to get from Shamanism to “cleanse” a person of these supernatural forces.

Another improperly done and ineptly reported acupuncture study has appeared. Julie Medew is the health editor for The Age, an Australian newspaper with an online presence. She authored an article yesterday with the headline:

Acupuncture as effective as drugs in treating pain, trial shows

The headline is accurate but falsely implies that acupuncture was effective, which most people will probably take to mean that acupuncture, by some as yet undiscovered means, really relieves pain. Many people will also jump to the conclusion that this is a good thing because drugs have side effects and acupuncture doesn’t. Is that true? It’s not obviously true or intuitively true. We need evidence before we should accept such a claim. Many people will also jump to the conclusion that this is a good thing because acupuncture is cheaper than pain pills. Is that true? If it is, it is not obviously true or intuitively true. Where’s the evidence?

The School of Health Sciences engages in teaching and research in Complementary Medicine, Nursing and Midwifery, and Psychology.

We recognise that many of the greatest advances in Science are made at the intersections of disciplines. With our strong interdisciplinary approach we have set our sights on establishing an evidence base for the quality, safety and effectiveness of interventions for the ageing population and those with chronic diseases. Our research findings inform clinical teaching and advance the treatment of patients.

One can only hope that the quality of research in other areas investigated by this institution is superior to that reported on by Ms. Medew. According to her, the “randomised controlled study of about 550 patients” gave acupuncture to some and a”strong oral analgesia, such as Endone, Panadeine Forte, Voltaren and Valium” to others. Medew reports that Dr Michael Ben-Meir “said it showed acupuncture offered the same level of pain relief as analgesic drugs when patients rated their pain one hour after treatment.” You read that right. The conclusion that acupuncture is as effective as pain pills was based on asking the patients about their pain level one hour after treatment. Was there a group of patients in the study who were give a dummy pain pill or fake acupuncture? No, but there was a group given both acupuncture and a pain pill. Guess what? After one hour, their reported pain level didn’t differ from those given only acupuncture or only a pain pill.

The word “pseudoscience” is used to describe something that is portrayed as scientific but fails to meet scientific criteria.

This misrepresentation occurs because actual science has creditability (which is to say it works), and pseudoscience attempts to ride on the back of this credibility without subjecting itself to the hard intellectual scrutiny that real science demands.

A good example of pseudoscience is homoeopathy, which presents the façade of a science-based medical practice but fails to adhere to scientific methodology.

Other things typically branded pseudoscience include astrology, young-Earth creationism, iridology, neuro-linguistic programming and water divining, to name but a few.

What’s the difference?

Key distinctions between science and pseudoscience are often lost in discussion, and sometimes this makes the public acceptance of scientific findings harder than it should be.

Other misconceptions about science include what the definition of a theory is, what it means to prove something, how statistics should be used and the nature of evidence and falsification.

Because of these misconceptions, and the confusion they cause, it is sometimes useful to discuss science and pseudoscience in a way that focuses less on operational details and more on the broader functions of science.

What is knowledge?

John DeweyCredit: Encyclopædia Britannica, Inc.

The first and highest level at which science can be distinguished from pseudoscience involves how an area of study grows in knowledge and utility.

The philosopher John Dewey in his Theory of Inquiry said that we understand knowledge as that which is “so settled that it is available as a resource in further inquiry”.

This is an excellent description of how we come to “know” something in science. It shows how existing knowledge can be used to form new hypotheses, develop new theories and hence create new knowledge.

It is characteristic of science that our knowledge, so expressed, has grown enormously over the last few centuries, guided by the reality check of experimentation.

In short, the new knowledge works and is useful in finding more knowledge that also works.

No progress made

Contrast this with homeopathy, a field that has generated no discernible growth in knowledge or practice. While the use of modern scientific language may make it sound more impressive, there is no corresponding increase in knowledge linked to effectiveness. The field has flat-lined.

At this level of understanding, science produces growth, pseudoscience does not.

To understand this lack of growth we move to a lower, more detailed level, in which we are concerned with one of the primary goals of science: to provide causal explanations of phenomena.

I am not a medical doctor and I don’t even play one on TV! So how am I qualified to write about Chinese medicine? Well because I grew up with it! Is that really good enough? Yes, and every Chinese who grew up in a Chinese household in a Chinese community are inculcated with knowledge about Chinese medicine and how it works. Like any other Chinese kid growing up, when I was sick my mother could quickly diagnose my illness and if she couldn’t, she could turn to her mother or aunts or other higher authority figures. In more severe cases, there’s always the guy selling herbs. No formal training is required. By osmosis, we were all supposed to have absorbed medical knowledge and know what foods – plant/animal parts would be good medication for whatever ailed us. I now live in a region of the U.S. very much enamored with eschewing Western evidence-base medicine for herbal treatments, acupuncture, and other Traditional Chinese Medicine (TCM) cures. I can usually provoke shock and jaw-dropping silence when my response to questions about TCM is that I want nothing to do with it when it comes to the health and well-being of my family. The two primary arguments in favor of TCM involve the classic logical fallacy of argument from antiquity and conspiracy theory about the evil intents of “Big Pharma. I will confine the rest of this blog to discussing the totally unscientific and perhaps even anti-scientific origins of TCM and leave debunking the Big Pharma Conspiracy to my fellow skeptics.The argument from antiquity in favor of TCM usually goes like this: it’s been around N-thousand years (replace N with your favorite integer between 1 and 5) and so it must have worked well! The truth of the matter is that TCM has no scientific basis and has been developed over the years on a foundation of very flawed understanding of the human anatomy and physiology. Historically, the pathetically low cure-rate of diseases plaguing the Chinese population with access only to TCM resulted in the evolution of a hyper-superstitious culture bent on seeing ghosts and goblins around every corner and behind every bush, too ready to take another life away. The inefficacy of their medical treatments throughout history, in my opinion, is responsible for the Chinese culture’s obsession with superstitions associated with maintaining good health and longevity. The list of superstitious do’s and don’ts are especially long when it came to childbirth, prenatal and postnatal care. Please note that I am not talking about ancient history or even 100 years ago – I am talking about the persistence of these superstitions today in very modern Chinese communities in Hong Kong, Singapore, Taiwan and big modern cities in China.

To understand TCM, you do not need to understand chemistry, biology, anatomy or physiology because the foundation of TCM has nothing to do with them. You need instead to understand Taoism and Confucianism, as these philosophies are the founding principles of TCM. I will expend some ink here to explain these two very powerful underlying influences on Chinese society which gave rise to their understanding of the human body and the attendant medical fallacies.

The discoverer says that a powerful establishment is trying to suppress his/her work. Special pleading for a conspiracy is just a logical fallacy. If someone discovers a cure for all cancers (probably not possible, since there are so many different cancers), the powers that be will be bringing truckloads of dollars to buy it, because they could market it for even more truckloads of money. But if you have no evidence that it cures all cancers, you’re not going get anything.

The scientific effect is always at the very limit of detection. This is the very definition of “it doesn’t work.” Moreover, if the thing being promoted has a tiny effect, then more of it will have more of an effect, the typical dose-response relationship expected from all compounds.

Evidence for a discovery is anecdotal. Anecdotes are not data. More anecdotes are not data. Anecdotes are not controlled, but they are subject to all sorts of bias. Like confirmation bias, where the observer only picks anecdotes that support their belief. The problem with that is we have no idea if the anecdote is, in fact, accurate; and we ignore all the data that does not support the anecdote. Randomized clinical trials remove bias, remove observer partiality, and blind the patients and the researchers to the experiment itself.

Despite all the information there is about alternative medicine and how not only does it not work, but that infact it can even be harmful, people still use it and believe that it really does work.

So why is it that people still use alternative medicine? Well, I’ve been thinking about that, and I’ve come up with quite a few reasons why:

Desperation

Science based medicine is an incredible thing and can cure many diseases and fix a lot of things that can go wrong with the human body, but unfortunately it can’t cure every disease, or fix everything that goes wrong with our bodies (not yet atleast). So when science based medicine can’t fix or cure what ever is wrong with us (or atleast not doing so in a way that is fast enough for us) some people, even rational people, might become desperate enough to use alternative medicine.

This sort of situation especially happens when someone has a terminal disease and they are told by their doctor that there is nothing they can do to cure what ever it is that is killing them. Some people will not accept this and will seek out anything that is claimed to be able to cure them (even if all the evidence says otherwise).

They think it’s cheaper

Because alternative medicine isn’t manufactured by the pharmaceutical companies (who are for profit businesses) it is assumed by some people that alternative medicine must be cheaper than science based medicine because they believe that the people who are manufacturing these alternative medical products are not doing it for a profit, plus when a person is told about a product that is suppose to be cheaper and work better than the conventional product, people tend to buy the supposedly cheaper product.

Now if you seriously believe that alternative medicine is cheaper than science based medicine, and that people who make these alternative medical products are not doing so for a profit, then I know a Nigerian prince that wants to give you $15,000,000.

A friend told them it works

Probably the best form of advertising there is is word of mouth. You don’t do have to pay for anything, and people tend to trust the opinion of a friend or family member over a creative ad in a newspaper or a TV commercial. Same thing holds true with alternative medicine.

Lets say you’ve been sick for a while and you have been taking some medicine for what ever has been ailing you, but so far it has had little to no affect. You tell a friend or a family member about your health issues and they might recommend that you take some herbs, or to go see this “doctor” that they recommend (who turns out to be an alternative medicine practitioner and not a real doctor) because they claim that it helped them, or it helped someone they know. Because you trust the person whom is recommending this “doctor” or this product, you might be more willing to see this “doctor” or try this product than you would if some stranger had told you.

Science based medicine can be harsh

Science based medicine (or modern medicine, or real medicine as some people like to call it) is a great thing. It has cured a lot of stuff, and has extended our average life expectancy by years, but it can also be pretty harsh at times as well. Because of this some people might either choose to stop using a science based medical treatment because they feel that it has become to harsh on them and that they believe that it might kill them if they continue to use, and so they decided to use alternative medicine instead because they believe it will help them without any side effects, or they might already know (or atleast believe) that the medical treatment that they’ve been recommend that they do could or will be harsh on them, and they decide to forgo it and use alternative medicine instead.

In a nutshell: Acupuncture is a kind of energy medicine. Needles are stuck into various parts of the body to unblock energy and bring back a balance of yin-yang. There is no scientific evidence for this energy or yin-yang.

Acupuncture is the puncturing of the skin with sharp needles to unclog an invisible energy that some people think runs through everything in the universe.

Even though millions of people believe this energy, called chi (ch’i or ki, pronounced chee), and the forces of yin-yang, flow in the human body through pathways called meridians, scientists have never found chi, yin, yang, or the meridians in which they flow.

Yin and yang are ideas found in Chinese stories written long before the rise of science. To explain yin-yang Chinese writers sometimes point to how mountains can’t exist without valleys or the inside of a bowl (whose shape is concave) can’t exist without the outside of the bowl (whose shape is convex).

Some people believe that to be healthy you must have a balance of yin-yang. The acupuncturist sticks the needles in special points on the skin (called acupoints). Each point is chosen by what hurts the patient. For pain in the right cheek an acupoint might be on the left big toe or on the left ear.

Where did such a weird idea come from and why do so many people believe acupuncture is a good way to treat illness or pain?

Most people think acupuncture started in China thousands of years ago, but the truth is we don’t know when and where acupuncture began.

The word acupuncture isn’t Chinese, but Latin (acus=needle and punctura=a pricking). The first use of the word acupuncture that joined the idea of needling with chi, meridians, and yin-yang, was by a Frenchman named George Soulié de Morant (1878-1955). Morant spent nearly twenty years in China at the beginning of 20th century. For 40 years Morant traveled around Europe telling doctors about acupuncture.

the science says no

Biology is the study of living things. There is no biological basis for acupuncture as a way to make people healthy. Still, many people around the world say acupuncture works. What they mean is that they feel better or think they feel better after getting acupuncture. Many scientific studies have shown that when patients are stuck in the wrong acupoints or aren’t even stuck at all (though they think they are being stuck), they say they feel better. If a scientist has only the word of those who got either real acupuncture or fake acupuncture, she would not be able to tell who got which. About the same number in each group will say it works.

If fake acupuncture works as well as real acupuncture, then something funny is going on. Many people who get acupuncture do get better, but maybe getting better has nothing to do with unblocking energy or sticking needles in acupoints. Fake acupuncture isn’t unblocking energy, but it works just as well as real acupuncture.

In June of 2009 the British Homeopathic Association declared “homeopathy awareness week.” I obliged by writing a post making the public more aware of the superstitious nonsense that is homeopathy. I, in fact, want people to be aware of exactly what homeopathy is, because most of the public does not know what absurd pseudoscience it is.Now I have to extend the favor to naturopathy – because the US has declared October 7-13 Naturopathy Awareness Week. They managed to squeeze in this critical vote prior to shutting down the government. Here is the resolution:

S.Res.221 – A resolution designating the week of October 7 through October 13, 2013, as “Naturopathic Medicine Week” to recognize the value of naturopathic medicine in providing safe, effective, and affordable health care.

Sen. Barbara Mikulski (D-MD), who apparently is enamored of alternative medicine, sponsored the resolution. The resolution is not a law and does not have any specific effects, but it is concerning none-the-less. Pseudoscientists are always desperate for the trappings of legitimacy and respect. They have become quite good and finding creative ways to make it seem like their nonsense is legitimate, because they cannot gain the one true measure – actual scientific legitimacy.

Naturopaths could, for example, conduct high quality clinical research that would establish in a convincing way that one or more of their preferred treatment methods are safe and effective, equal to or superior to standard medical care. They can’t do that, however, because their treatments are largely nonsensical and worthless, so instead they seek to have naïve politicians give them the recognition they crave.

Naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing process. The practice of naturopathic medicine includes modern and traditional, scientific, and empirical methods.

This, of course, is propaganda and spin. They claim to use “scientific and empirical methods,” but that is mainstream science-based medicine. If they really used scientific and empirical methods, they would be practicing mainstream medicine.

The focus on the “inherent self-healing process” is a little closer to the truth, in that they tend to use modalities that make that claim. CAM practitioners in general have relied upon the “self-healing” gambit because they cannot actually treat diseases or identifiable entities – because their treatments do not work, because they are not based in reality.

Saying that a treatment “supports the body’s self-healing ability” is just hand-waving marketing hype. It gets around the fact that they do not have a plausible biological mechanism addressing a specific biological problem.

This claim is often attached to energy-based or vitalistic treatments, those that are based on the pre-scientific superstition that living things have their own “life energy” which is responsible for health. No such life energy exists, and therefore any practice based upon the notion of such energy is hopelessly worthless.

In practice naturopaths cobble together a wide range of unscientific, disproven, discarded, and fanciful treatments. They seem to prefer treatments that do not work to those that are safe and effective. Since regular medicine uses science to determine which treatments are safe and effective, this is the only way to distinguish themselves.

It’s a multi-billion dollar scam industry that millions of people around the world use the products and services of year after year.

Many people who use alternative medicine will say it works, while many, many others will say otherwise.

Now there are a lot of things that I have notice about alternative medicine, but I have narrowed it down to five different things.

So here are five things I’ve noticed about alternative medicine:

5. It has a lot to do about nothing.

Alternative medicine products and services basically comes in two different forms: does nothing and uses nothing.

Most alternative medicine just doesn’t work at all (such as homeopathy), and the few that actually does do something, the effects are minor and no where near as effective as real medicine, and could even be harmful if done improperly.

Then there are some that not only does nothing, but uses nothing as well. Reiki healing is a prime example of this as practitioners of Reiki healing practitioners claim that they use “energy” from some unknown source to “heal” people. Sometimes they will use crystals to harness this power. Sometimes they’ll just use their hands. Regardless of how they “harness” this energy, they all do the same thing: nothing.

Some of the best “evidence” that practitioners of alternative medicine have about how effect the products and services they offer works is anecdotal evidence. In fact it’s not just best evidence they can give, it’s also often the only evidence they can ever give (besides the stuff they make up) mainly because scientific experimentation and testing have proven that their products and services are useless.

Most practitioners of alternative medicine will tell you that their products and services does make people feel better, what they often don’t tell you is how long it took to fix or cure whatever was ailing those who used their products or services, or whether they were using real medicine and medical services along with the alternative medicine, or how many people it didn’t work for and ended up having to go and get real medicine and medical services when the alternative medicine failed to cure any thing but perhaps a heavy wallet. And that’s another thing about alternative medicine…

3. It gets expensive.

Some alternative medicine is cheap (or at least it seems that way) but a lot of it is either over priced and even cost to much for some to use (which can be a good thing in a way, because the expense forces that person to go get real medicine). Even for people with health insurance it can still get expensive because most health insurance companies will not pay for alternative medicine, so a person who wants to use alternative medicine will have to pay for it out of pocket.

Even for the alternative medicine that isn’t expensive, and can still get expensive because . . .

Baton Rouge, LA-When investigators climbed from out of the smoldering debris that was the home of Hank Thomas, the looks on their faces told the gathering crowd what these hardened veterans of the Baton Rouge Fire Department couldn’t put into words. Thomas, a yoga instructor and avid fisherman who had lived in Baton Rouge his entire life, had exploded. And as the grisly details slowly emerge, people are asking questions about what might be to blame and how they can prevent being the next Baton Rougian to erupt into a massive fireball of body parts and Tony Chachere’s Creole Seasoning.

Some local medical professionals have proposed a controversial theory. Based on reports that Thomas has undergone acupuncture treatments for sciatica several times in the weeks preceding his untimely fulmination, a group of local experts are speaking out. They are warning the community to beware of discount acupuncture clinics.

“We aren’t saying that every incidence of spontaneous human combustion is linked to the incorrect placement of acupuncture needles,” Kuang Zhu LAC, Chief of Pragmatic Acupuncture in the Health and Wellness division of Vic’s Day Spa and Pet Grooming Center, explained during a recent press conference. “But in some cases, there is a relationship that is hard to explain otherwise.”

Zhu, a legally licensed acupuncturist in Baton Rouge, Louisiana for over thirty years and founder of the “Know Your Needler!” campaign, is reaching out to the Baton Rouge community because of concerns that there are patients seeking care from unlicensed and poorly trained practitioners that don’t charge as much per session. “These rogue needle-wielding impersonators don’t fully grasp the power of acupuncture, acupressure, sonopuncture, electroacupuncture, cold laser therapy, or any of the other ancient techniques of stimulating specific acupoints. With great ability to heal, comes an equal ability to harm.”

Acupuncture, a component of Traditional Chinese Medicine developed sometime in the past 5,000 years, involves the insertion of small needles into specific points on the body in order to improve the flow of life energy or Qi. These points are found along meridians, major pathways in the body through which our life energy courses that are different from blood vessels, nerves and lymphatics in that Western science has been unable to locate them during anatomical investigation or with modern imaging techniques. When Qi is obstructed, it becomes stagnant and illness develops. Properly placed needles relieve this obstruction and improve our health in a number of ways. Needles placed haphazardly can, according to Zhu, lead to further obstruction, a worsening of one’s health, and perhaps even a fiery death.

Zhu states that the phenomenon of injury by inappropriate acupuncture is not new. He has seen countless milder cases over his three decades of practice in the United States. But the worst occurred during his childhood in China. “Neighborhood gangs and even local police forces would use purposefully incorrect acupuncture as punishment or as an interrogation enhancer,” Zhu revealed. “Once I saw a body with the hao zhen needles still inserted in acupoints I did not even know existed. Oh, the disharmony! My childhood ended that day. I’ve heard that the American military is even using acupuncture on the battlefield now.”

But not every local acupuncturist supports Zhu’s theory that excessive and erroneous needle placement is to blame for unexplained explosions of American citizens. Frank Grimes, a Baton Rouge chiropractor who incorporates acupuncture into his armamentarium of healing modalities, reminds us that correlation doesn’t always equal causation. “Yes, some of the remaining body parts have been found with needles still in them,” He admits. “But my concern is that linking acupuncture to spontaneous human combustion is akin to the claim that chiropractic manipulation of the neck causes strokes. Perhaps people who are already about to explode seek out acupuncture for symptomatic relief.”

At the heart of this issue for Zhu and his colleagues is the health of their community. He admits that acupuncture-induced detonation is likely rare despite the recent occurrence, and that most people who receive acupuncture from improperly trained practitioners will at most only experience mild stagnation of Qi.

The pragmatic fallacy is committed when one argues that something is true because it works and where ‘works’ means something like “I’m satisfied with it,” “I feel better,” “I find it beneficial, meaningful, or significant,” or “It explains things for me.” For example, many people claim that astrologyworks, acupuncture works, chiropractic works, homeopathy works, numerology works, palmistry works, therapeutic touch works. What ‘works’ means here is vague and ambiguous. At the least, it means that one perceives some practical benefit in believing that it is true, despite the fact that the utility of a belief is independent of its truth-value.

The pragmatic fallacy is common in “alternative” health claims and is often based on post hoc reasoning. For example, one has a sore back, wears the new magnetic or takionic belt, finds relief soon afterwards, and declares that the magic belt caused the pain to go away. How does one know this? Because it works! There is also some equivocation going on in the alternative health claims that fall under the heading of “energy medicine,” such as acupuncture and therapeutic touch. The evidence pointed to often uses ‘works’ in the sense of ‘the customer is satisfied’ or ‘the patient improves,’ but the conclusion drawn is that ‘chi was unblocked’ or ‘energy was transferred.’

There is a common retort to the skeptic who points out that customer satisfaction is irrelevant to whether the device, medicine, or therapy in question really is a significant causal factor in some outcome. Who cares why it works as long as it works? You can argue about the theory as to why it works, but you can’t argue about the customer satisfaction or the fact that measurable improvements can be made. That’s all that matters.

It isn’t all that matters. Testimonials are not a substitute for scientific studies, which are done to make sure that we are not deceiving ourselves about what appears to be true. It is especially necessary to . . .

Psychics, and alternative medicine practitioners. Two different groups of people who peddle BS pseudoscience that wastes gullible peoples money. But which one is worse?

Now many people would say that alternative medicine practitioners are worse, because not only are they peddling something and taking peoples’ money for products and services that do not work, they’re also physically harming people as well, and even risking peoples lives by not only selling them products and services that makes them think they can forgo real medicine and medical services that could help them and even save their lives for the alternative stuff, but also selling them products and services that really can cause harm, and possibly even kill you.

So it sounds like a no brainer, right? Alternative medicine practitioners are selling you products and services that could harm you and possibly kill you, while psychics are just taking your money. Except… many alternative medicine practitioners might not know what they are doing is harmful, because some do seriously believe that alternative medicine does work (this is mostly due to anecdotal evidence).

People claiming to be psychics on the other hand are different, because while many alternative medicine practitioners might not know what they’re doing is fraud, psychics on the other hand almost always know what they’re doing is fraud.

Psychic powers simply do not exist. Every person who has ever been tested for psychic powers under controlled scientific testing conditions have always failed to prove that they have psychic powers, and the really famous so called psychics have never gone and had their alleged powers proven under controlled scientific testing conditions, so it is very safe to say that psychic powers don’t exist, and that anyone who is claiming to be a psychic is most likely lying (although it is also possible that they may be self-deluded and have actually convinced themselves they are psychic, or they’re just mentally ill) and therefore if they do take any money from you for their services, are knowingly committing fraud.

Experts in the psychology of human error have long been aware that even highly trained experts are easily misled when they rely on personal experience and informal decision rules to infer the causes of complex events. —Barry Beyerstein

Integrative medicine is a synonym for “alternative” medicine that, at its worst, integrates sense with nonsense. At its best, integrative medicine supports both consensus treatments of science-based medicine and treatments that the science, while promising perhaps, does not justify.

Andrew Weil

It mixes the scientific with the metaphysical (“spirit-mind-body connection” is a favorite expression) and the scientifically untested, discredited, or questionable. Defenders of integrative medicine have an exceptionally high opinion of things “natural” or “organic.”

Weil graduated from Harvard Medical School but did not complete a residency nor, as far as I can ascertain, ever take the medical boards in any state.

According to [Andrew] Weil, many of his basic insights about the causes of disease and the nature of healing come from what he calls “stoned thinking,” that is, thoughts experienced while under the influence of psychedelic agents or during other states of “altered consciousness” induced by trances, ritual magic, hypnosis, meditation, and the like. —Arnold S. Relman, M.D.

[ . . . ]

Today, Weil mixes scientific medicine with Ayurvedic and other forms of quackery and calls this practice “integrative medicine.” One of his main tenets is: “It is better to use natural, inexpensive, low-tech and less invasive interventions whenever possible.” However, there is no scientific evidence for the claim that natural interventions are always superior to artificial ones. Millions of people use herbs and natural products for a variety of conditions, such as calcium, echinacea, ginseng, ginkgo biloba, glucosamine, saw palmetto, shark cartilage, and St. John’s wort. All of these, when tested scientifically, have failed to support the traditional wisdom regarding their healing powers. Pharmaceuticals and other treatments are much superior to most herbal remedies. If a plant has been shown to be effective as a healing agent, the active ingredient has been extracted and tested scientifically and is part of scientific medicine. Otherwise, any beneficial effect following use of the herb or plant is probably best explained as due to the placebo effect, natural regression, the body’s own natural healing processes, or to some other non-herbal factor.

Why so many people—including many highly educated and medically trained people—believe in the efficacy of quack remedies is a complex issue. As Barry Beyerstein has pointed out in his most thorough analysis of this phenomenon, there are a “number of social, psychological, and cognitive factors that can convince honest, intelligent, and well-educated people that scientifically-discredited [or untested] treatments have merit” (Beyerstein 1999). The typical believer in untested or discredited medical treatments accepts uncritically the apparently clear messages of personal experience that such treatments are effective. To the uncritical thinker, many worthless or harmful treatments seem to “work” (the pragmatic fallacy). Such people are either unaware of or intentionally ignore the many perceptual and cognitive biases that deceive us into thinking there are causal relationships between quack treatments and feeling better or recovering from some illness or disease. They uncritically place “more faith in personal experience and intuition than on controlled, statistical studies” (Beyerstein 1999).

Furthermore, the mass media is rarely critical of “alternative” healing and often presents non-scientific medicine in a very positive light. And critics of complementary and alternative medicine (CAM) are often . . .

PHILADELPHIA — The 12-year-old girl arrived at the hospital wracked with abdominal pain.

Doctors diagnosed her with acute pancreatitis, in which pancreatic enzymes begin digesting not just food, but the pancreas itself.

The most likely cause of the girl’s condition: toxic side effects from more than 80 dietary supplements, which the girl’s mother carried in a shopping bag, says Sarah Erush, clinical pharmacy manager at Children’s Hospital of Philadelphia, where the girl was treated last summer.

The girl’s mother had been treating her with the supplements and other therapies for four years to treat the girl’s “chronic Lyme disease,” a condition that, experts say, doesn’t actually exist. While some Lyme infections cause pain and other lingering symptoms, the infections don’t persist for years. And, according to the Infectious Disease Society of America, the infections don’t require years of antibiotics or other risky therapies given by some alternative medicine practitioners.

Doctors were able to control the girl’s illness with standard therapies, Erush says, and she was discharged from the hospital after two weeks.

Although the child’s story was unforgettable, Erush says, it wasn’t unusual. Parents now “routinely” bring children to her hospital with a variety of alternative remedies, hoping that nurses will administer them during a child’s stay.

There are an ever-growing number of supplements from which to choose: More than 54,000 varieties sold in stores and the Internet, according to the Food and Drug Administration.

About 50% of Americans use alternative medicine, and 10% use it on their children, notes Paul Offit, Children’s Hospital’s chief of infectious disease.

The girl’s story illustrates the serious but often little-known risks posed by some forms of alternative medicine, a loosely regulated industry that includes everything from herbal supplements to crystal healing and acupuncture, says Offit, author of Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine, (HarperCollins, $29.99), being published Tuesday

Many consumers view alternative medicine industry as more altruistic and home-spun than Big Pharma. But in his book, Offit paints a picture of an aggressive, $34 billion a year industry whose key players are adept at using lawsuits, lobbyists and legislation to protect their market.

“It’s a big business,” says Offit, best known for developing a vaccine against rotavirus, a diarrheal illness that killed 2,000 people each day, mostly children in the developing world.

About a year ago the editors of Anesthesia & Analgesia solicited a written debate on whether or not acupuncture is effective or simply an elaborate placebo. Four experienced acupuncture researchers agreed to write the pro-acupuncture article, Wang, Harris, Lin and Gan.

The article is fortunately published in open access, and so I can reprint it here (full article is below). What I think David and I convincingly demonstrated is that, according to the usual standards of medicine, acupuncture does not work.

Let me explain what I mean by that. Clinical research can never prove that an intervention has an effect size of zero. Rather, clinical research assumes the null hypothesis, that the treatment does not work, and the burden of proof lies with demonstrating adequate evidence to reject the null hypothesis. So, when being technical, researchers will conclude that a negative study “fails to reject the null hypothesis.”

Further, negative studies do not demonstrate an effect size of zero, but rather that any possible effect is likely to be smaller than the power of existing research to detect. The greater the number and power of such studies, however, the closer this remaining possible effect size gets to zero. At some point the remaining possible effect becomes clinically insignificant.

In other words, clinical research may not be able to detect the difference between zero effect and a tiny effect, but at some point it becomes irrelevant.

What David and I have convincingly argued, in my opinion, is that after decades of research and more than 3000 trials, acupuncture researchers have failed to reject the null hypothesis, and any remaining possible specific effect from acupuncture is so tiny as to be clinically insignificant.

In layman’s terms, acupuncture does not work – for anything.

This has profound clinical, ethical, scientific, and practical implications. In my opinion humanity should not waste another penny, another moment, another patient – any further resources on this dead end. We should consider this a lesson learned, cut our losses, and move on.

I suspect, however, human nature being what it is, that this will not happen anytime soon.

The Internet is a dangerous place. It’s full of resources, both good and bad; full of citations linking one to another, sometimes helpfully, sometimes not. Today we’re going to point the skeptical eye at ten of the worst web sites in terms of quality of science information that they promote. To make this list, they not only need to have bad information, they also need to be popular enough to warrant our attention.

Many of these sites promote some particular ideology, but I want to be clear that that’s not why they’re here. Sites that make this list are only here because of the quality of the science information that they advocate.

As a measure of each site’s popularity, I’m giving its ranking on Alexa.com as of this writing. Of course this changes over time, so I’m rounding them off to give a general idea of each site’s traffic. Also, I’m giving its US traffic ranking, as these are English language sites and the worldwide rankings are skewed by sites in China, Russia, and the rest of the non-English world. For a starting point of reference, Skeptoid.com’s ranking is currently about 40,000, meaning that 40,000 web sites in the United States get more traffic than I do. And, compared to the number of web sites there are, that number is actually not half bad — but note how it compares to some of these sites promoting misinformation.

Let’s begin at the bottom of our list of the worst offenders, with a site that nevertheless has staggering amounts of traffic:

The Huffington Post is arguably one of the heaviest trafficked news, opinion, and information sources on the Internet. Its many editors and 9,000 contributors produce content that runs the gamut and is generally decent, with one exception: medicine. HuffPo aggressively promotes worthless alternative medicine such as homeopathy, detoxification, and the thoroughly debunked vaccine-autism link. In 2009, Salon.com published a lengthy critique of HuffPo’s unscientific (and often exactly wrong) health advice, subtitled Why bogus treatments and crackpot medical theories dominate “The Internet Newspaper”. HuffPo’s tradition is neither new nor just a once-in-a-while thing.

Science journalists have repeatedly taken HuffPo to task for this, and repeatedly been rebuffed or not allowed to submit fact-based rebuttals. HuffPo’s anti-science stance on health and medicine appears to be deliberately systematic and is unquestionably pervasive.

Conservapedia was founded by Christian activist Andrew Schlafly as resource for homeschooled children, intended to counter what he saw as an anti-Christian bias in Wikipedia and science information in general. It is, in short, an encyclopedia that gives a Young Earth version of every article instead of the correct version. If you want to know about dinosaurs, geology, radiometric dating, the solar system, plate tectonics, or pretty much any other natural science, Conservapedia is your Number One resource to get the wrong answer. That it is intended specifically as a science resource for homeschooled children, who don’t have the benefit of an accredited science teacher, is its main reason for making this list.

Run by cryptozoologists Loren Coleman, Craig Woolheater, John Kirk, and Rick Noll, Cryptomundo promotes virtually every mythical beast as being a real living animal. Cryptozoology may be a fun and illustrious hobby for some, but its method of beginning with your desired conclusion and working backwards to find anecdotes that might support it is pretty much the opposite of the scientific method. Cryptomundo only ranks as #8 on our list because, let’s face it, cryptozoology is not exactly the most harmful of pseudosciences. It’s more of a weekend lark for enthusiasts of the strange.

Cryptomundo’s forum moderators have something of a notorious reputation for editing comments posted by site visitors, and for deleting comments that express skeptical points of view. Some skeptical commenters have reported even being banned completely from the forums, not for spamming or trolling, but just being consistently skeptical.

The only reason this site has such a low traffic rating is that its field is saturated with competition. 9/11 Truth.org is only the largest of the many, many web sites who began with the idea that 9/11 was a false flag operation against American citizens staged by the American government, but unlike most others, it has stayed on topic. Even more than a decade after 9/11, 911 Truth.org still manages to find and post articles almost daily promising to reveal new evidence proving the conspiracy.

The sales portal of alternate medicine author Joseph Mercola has received at least three warnings from the U.S. Food and Drug Administration to stop making illegal health claims about the efficacy of its products. A tireless promoter, Mercola has built his web site into probably the most lucrative seller of quack health products. But Mercola’s web site is not wrong because it’s lucrative; it’s wrong because the vast majority of its merchandise has no proven medical value, yet virtually all of its product descriptions imply that they can improve the customer’s health in some way. Today’s Featured Products include:

Probiotics supplements that can “boost your body’s defense against disease and aid your production of essential nutrients”.

At least Mercola.com usually includes the required statement (tucked way down at the bottom of the screen in a tiny font) that “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.” Presumably that’s a result of all the regulatory action he’s suffered.

There is a clichéd saying regarding open-mindedness: “Keep an open mind — but not so open that your brain falls out”.

This piece of advice is most often said to come from physicist Richard Feynman (1918-1988), but also a slew of other more or less famous people, most of them from the field of science: Richard Dawkins, Carl Sagan, James Oberg, Bertrand Russell, J. Robert Oppenheimer. It’s plausible that they all certainly said it at one time or another because it applies every time one is presented with a fringe or alternative explanation for something. It’s well worth remembering as a rule of thumb.

Because I peruse paranormal-themed sites and various “water-cooler” forums on the web, I frequently see ideas thrown out there that would qualify as amazing and paradigm-shifting. So, what do I think about this latest crazy thing, people ask?

The Starchild skull.

Here’s a recent example. With all the recent speculation about “alien” remains, someone on Facebook mentioned Lloyd Pye who contends (for almost 15 years now) that a curiously-shaped skull he has is that of an alien-human hybrid. Called the “star child” skull, Pye promotes the story that this is proof that humans descended from extraterrestrial beings.

The plausibility of this idea is practically nil. There is no decent evidence in support of it except a nifty story. To accept it, we’d have to throw out all of what we know about human history, evolution, and a good bit of well-established physics. Just because of one odd-looking skull? No, thank you. That would be stupid. Thus, to consider such an idea takes me about a minute before I realize that would be unreasonable. It’s an imaginative idea, just like mermaids and remote viewing and time travelers. But in order to accept it, I’d have to discard too much (e.g., my brain and society’s accumulated knowledge). The evidence clearly suggests another more down-to-earth explanation. Since the skull DNA tested as human, and we know that certain genetic conditions can cause the enlargement of the skull in just this way, I’m going to accept the obvious and not some far-fetched story just for kicks.

Calling skeptics closed-minded because we discard wacky ideas is a common ploy. It’s often used as a personal insult because the skeptic has rejected a baseless idea that the promoters fancy. When you don’t have evidence to support your idea, observe that the proponent resorts to derogatory tactics.

“But all ideas are not equal. Not all ideas are worthy of consideration.”

It’s not about actually being open-minded towards new ideas. Instead, the proponent is accusing the skeptic of being stubborn, undemocratic and unfair. They see it as the skeptical person, being overly rational, ignoring a possibly worthwhile option to be considered. But all ideas are not equal. Not all ideas are worthy of consideration.

Let’s take another example: energy healing. I should be open-minded, reiki practitioners say, and try these forms of energy medicine where healing energy gets channeled or manipulated for better health. If someone offers these treatments to me and I just say “OK! Sounds good!” (and hand over my money) is that actually being open-minded? No. It’s swallowing what I’m being fed without a thought. The same would apply to . . .

So-called complementary and alternative medicine (CAM) is largely philosophy-based medicine rather than science based. There are a few core concepts that are endlessly recycled in various forms, but it is mythology and culture, not grounded in the rigorous methods of science that allow us to tell the difference between our satisfying fantasies and hard reality. Sometimes proponents of such philosophies try to cloak their beliefs in the appearance of science, resulting in what we simply call pseudoscience.

Harriet Hall coined an excellent term to refer to such pseudoscience –” Tooth Fairy science.” In her metaphor, pseudoscientists sometimes act like scientists by describing the details and statistics of their claimed phenomenon (such as examining all the details of the Tooth Fairy phenomenon) without ever testing the reality of the phenomenon itself. The fundamental concept at the core of their belief is never challenged, or only superficially so, and they proceed prematurely from their faulty premise.

Another term that I find extremely apt is “Cargo Cult science,” a term coined by Richard Feynman. This is a reference to the cargo cults of New Guinea – the pre-industrial tribes were observed building straw mock-ups of control towers, planes, and runways in hopes that the planes they observed flying over head would deliver their cargo to them. In other words – the cargo cults mimicked the superficial appearance of an aviation infrastructure but had none of the real essence or function (because of lack of understanding). This is a perfect analogy to much of what passes for science within the world of CAM.

Not that we need another analogy, but I have often described such pseudoscience as being lost in the noise. In any endeavor to detect something there is the issue of the signal to noise ratio. Often the core challenge of scientific research is pulling the signal out from the background noise, or (more to the point) deciding if there is a signal in the noise, or if the information represents pure noise. In this analogy “noise” refers to any randomness in the data or interference from effects other than the alleged signal of interest. What I find is that pseudoscientific investigations of tooth fairy phenomena are completely lost in the noise of data, seeing whatever phantom “signals” support their philosophy. Elaborate but entirely illusory constructs are often crafted (or retrofitted to) these phantom signals.

Energy medicine began its life as a philosophy-based notion, and is still philosophy-based, but many of its modern practitioners are desperate for the respectability that science has to offer. Some have therefore erected a pseudoscientific facade for this pre-scientific superstition.

One example I was recently asked to investigate is the Heartmath institute., which promotes an energy-medicine based claim that the heart sends out “energy” waves that regulate the body, including the brain.

Since 1997, the JREF’s annual Pigasus Awards have been bestowed on the most deserving charlatans, swindlers, psychics, pseudo-scientists, and faith healers—and on their credulous enablers, too. The awards are named for both the mythical flying horse Pegasus of Greek mythology and the highly improbable flying pig of popular cliche. These are the awards for 2012. Find out more about this year’s winners here: http://ow.ly/jDZwg

Alternative medicine is a really big business, and is practiced around the world (in some places more than others).

In some place in the world it might be practiced because the people there either can’t afford modern medicine, or more likely they either just can’t get access to modern medicine, or they feel they have no need for modern medicine because they have been taught that their local folk medicine works. In other places in the world it could be just simply that they don’t trust pharmaceutical companies.

So back at the subject at hand, alternative medicine can be basically categorized into three different types:

Ineffective

While many people might say that no forms of alternative medicine work, there are in fact a few that do work to some extent, they just don’t do to the extent that many of the practitioners of that alternative medicine claims, and that there are more effective (and sometimes cheaper) conventional medical practices that can be done.

Examples of this would be acupuncture, chiropractic therapy, and even vitamin supplements can be categorized into this group, and that is if these things done correctly, otherwise some of these things could be not effective at all, or even dangerous.

It should also be noted that this is the smallest category for alternative medicines as most alternative medical practices are like the next two categories.

Non-effective

This is the largest of the three alternative medicine categories as simply put, almost all alternative medical practices just do not work at all, and is mainly based off of anecdotal evidence, rather than real, scientific evidence.

Sometimes the targets of our skeptical analysis notice, and they usually are not pleased with the attention.

Last year the Acupuncture Trialists Collaboration published a meta-analysis of acupuncture trials in which they claim, “The results favoured acupuncture.” The report was widely criticized among those of use who pay attention to such things. In my analysis I focused on the conclusions that the authors drew, rather than their methods, while others also had concerns about the methods used.

The authors did not appreciate the criticism and went as far as to publish a response, in which they grossly mischaracterize their critics and manage to completely avoid the substance of our criticism.

To review, the original meta-analysis concluded:

Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture.

In my critique I pointed out that the results do not show that acupuncture is effective, nor that it is a reasonable referral option. What they characterize as “modest” differences were, rather, not clinically significant. Further, such tiny differences are most parsimoniously explained as the result of researcher and publication bias, two phenomena that are well established in general and specifically within the acupuncture literature. Unblinding alone would be sufficient to explain these results.

What they call “factors in addition to the specific effects of needling” the rest of the scientific community would call “placebo effects,” which are not an indication that a treatment works, but rather the result of bias, noise, and statistical illusions. These results are due to unblinded comparisons with untreated groups in clinical trials – they are not evidence of any kind of efficacy.

Their conclusions are part of a pattern visible within the acupuncture community – attempting to parlay placebo effects into the mirage of a real effect from acupuncture. I commented in my original article that such a conclusion was evidence of pro-acupuncture bias in the authors.

In their response, the authors write:

Although there was little argument about the findings in the scientific press, a controversy played out in blog posts and the lay press.

Only one substantive critique of the paper has appeared in a scientific forum.

We find that there is little argument in the scientific press because most scientists pay little attention to what they consider fringe practices. That is precisely why it is left to those of us who do care and pay attention to fringe medicine to provide a detailed analysis and point out the flaws in reasoning used by proponents.

In fact we did submit a letter in critique of the study, in a traditional scientific forum, but it was not published. Only the brief letter by David Colquhoun was.

This represents a typical strategy by proponents of dubious fringe medicine – interpret lack of resistance by mainstream scientists as acceptance.

In September 2012 the Acupuncture Trialists’ Collaboration published the results of an individual patient data meta-analysis of almost 18 000 patients in high quality randomised trials. The results favoured acupuncture. Although there was little argument about the findings in the scientific press, a controversy played out in blog posts and the lay press. This controversy was characterised by ad hominem remarks, anonymous criticism, phony expertise and the use of opinion to contradict data, predominantly by self-proclaimed sceptics. There was a near complete absence of substantive scientific critique. The lack of any reasoned debate about the main findings of the Acupuncture Trialists’ Collaboration paper underlines the fact that mainstream science has moved on from the intellectual sterility and ad hominem attacks that characterise the sceptics’ movement.

Nope. Not close to the mark. There was plenty of substance in the critiques at the time include those from Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, who said the study “impressively and clearly” showed that the effects of acupuncture were mostly due to placebo. “The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies. Several investigations have shown that the verbal or non-verbal communication between the patient and the therapist is more important than the actual needling. If such factors would be accounted for, the effect of acupuncture on chronic pain might disappear completely.”